What is the difference between a food allergy and a food sensitivity? Food allergies are often referring to a reaction to an item resulting in a serious breathing problem or tissue swelling if ingested and potentially life-threatening responses can make it necessary to carry an Epipen at all times. These severe food allergies are type 1 "IgE" mediated food allergies. When someone references a food sensitivity, it usually refers to a much smaller immune response that compounds gradually over time with multiple food sensitivities. These responses are "IgG" mediated type 3 hypersensitivity reactions. Type 3 hypersensitivities can cause inflammation. Our office understands that living with even minor inflammation is not ideal. Inflammatory conditions caused by food sensitivities such as arthritis, obesity, eczema, sinus conditions, skin rashes, headaches/ migraines, and diarrhea (to name a few) can completely disrupt life. For this reason, we prefer to get to the root of the problem. With inflammation, the cause could be simply eating the wrong foods too often.

Let's explain the different types of hypersensitivity reactions that your immune system can cause.

Type 1

These are the responses that happen in less than 2 hours. They are a result of IgE antibodies binding with specific antigens to activate cell receptors on mast cells. The mast cells release chemicals in your body. These chemicals are irritating to body tissues and include leukotrienes, lysosomal enzymes, histamines, kinin, and bradykinin- like substances. Dehydroascorbic acid is also released, resulting in inflammation and irritation to tissues. Those tissues can be the trachea, tongue, mouth, lips, and eyelids. An example of this reaction is anaphylaxis when eating peanuts. These are fixed food allergies where any ingestion of the allergenic substance will always cause a response.

Type 2

These reactions are cytotoxic and cause cell destruction. These involve IgM and IgG immunoglobulins. These immunoglobulins bind to the surface of the cell, and then the cell is destroyed. An example of this can be a response to a drug that causes the destruction of red blood cells.

Type 3

These reactions have been shown to involve IgG antibodies and an example of a type 3 reaction is what we classify as food sensitivities. These are not fixed food allergies, but may be cyclical in nature. Type 3 reactions cause the immune system to deposit the formed complexes into tissues. The deposit can cause tissue injury and inflammation up to 72 hours after exposure to the offending agent.

Type 4

These reactions are not from immunoglobulins and instead involve T-cells. Inflammation of tissues can occur in 36-72 hours. An example of this reaction is contact dermatitis from poison ivy.

Now that we understand all four types of hypersensitivity, we will focus on the Type 3 response—food sensitivities. The immune system is your first defense against invaders in the body. If there is a protein that the immune system is exposed to and determines that it is foreign, it will attack this protein. The explanation of this response is rather vague because any complexes that your immune system makes can be deposited anywhere in your body. Some people may have more inflammation in one part of their body than another person. Some reports estimate that up to 50% of Americans suffer from food sensitivities. Often the inflammation can target the GI tract causing diarrhea and pain. Some of the notably prevalent offenders are wheat, milk, corn, cheese, oats, coffee, rye, eggs, and tea. It is also important to note, people who already suffer from seasonal allergies may have more inflammation from food sensitivities that exacerbate their seasonal allergies.

These type 3 hypersensitivity reactions can develop as a result of frequently eating the same food. For this reason, we suggest a rotational diet. We recommend that you only have the same foods 2-3 times per week as opposed to eating the same foods daily. This will lessen the amount your immune system is exposed to certain proteins and can decrease the chances of reacting and causing inflammation.

At this office, we do food sensitivity IgG testing through a lab called Alletess. They have two different panels- one for 96 foods and a more extensive panel with 212 foods. We can perform either test from a single blood draw. For our younger patients, we also offer a "finger poke" food allergy test which checks against 96 foods. These food panels help determine to what foods your body has an IgG response. Once a practitioner sees these results, they can inform you of what foods you need to remove from your diet. This is where the rotational diet becomes imperative. Based on your results, we suggest you eliminate certain foods for 3, 4, or 6 months. Once you begin to reintroduce certain foods, we recommend that you monitor for reoccurrence of inflammatory responses. Often we suggest that patients only introduce one new food per week to adequately determine their delayed response. Identifying inflammation may not occur for up to three days.

Currently, there is no known cure for allergies, but together we can help minimize responses by avoiding the foods triggering the inflammatory response. Our practitioners are here to partner with patients in determining what the offending agents are and develop a diet plan to help you avoid these foods. Decreasing inflammation in the body is our primary purpose as it will help patients feel better overall!